What new drugs are there for epilepsy? Are these drugs more effective?

As a broad-spectrum antiepileptic drug, the mechanism of LTG is to block voltage-dependent sodium channels and reduce the release of excitatory amino acids. Its protein binding rate is 55%, and its half-life is 15-30h, of which 90% is eliminated by the liver. Common side effects include ataxia, dizziness, diplopia, drowsiness, headache, convulsion and insomnia. Serious side effects include rash, Stevens-Johnson syndrome and toxic epidermal necrolysis, and allergic reactions such as liver and renal failure, disseminated intravascular coagulation (DIC) and arthritis may also occur. These conditions are more common in children, or when combined with enzyme inhibitors such as valproic acid (VPA). Karande et al. reported a case of antiepileptic drug hypersensitivity syndrome (AHS) caused by LTG. In vitro experiments confirmed that LTG caused lymphocyte death, and phenytoin sodium (PHT), phenobarbital (PB) and carbamazepine (CBZ) could also cause similar symptoms. Cunnington found that the teratogenicity of LTG was similar to other AEDs, about 2.9%. However, the number of sample cases is small, which needs further study to confirm. Enzyme-induced AEDs, such as phenytoin and CBZ, can increase the clearance rate of LTG when used together, while enzyme inhibitor VPA can reduce the clearance rate of LTG by about 60%. At present, other new aeds have not been found to have obvious effects on the clearance rate of LTG, but the probability of side effects increases after combined use. Contraceptives can reduce the blood concentration of lamotrigine, but there is no interaction with cytochrome P450 and warfarin.

Oxcarbazepine

Its mechanism is to block voltage-dependent sodium channels, with a protein binding rate of 40%, a half-life of 4-9 hours and a liver clearance rate of 70%. Common side effects include drowsiness, dizziness, headache, ataxia, nausea, vomiting, diplopia, blurred vision, dizziness, hyponatremia and rash. The possibility of finding hyponatremia increases with age. Previous studies have shown that the offspring of pregnant women who took oxcarbazepine as a single drug to treat epilepsy did not show an increase in the incidence of malformation. OXC can increase the blood concentration of PHT or PB. At present, there is no interaction between OXC and erythromycin, and OXC can reduce contraceptives and ethinylestradiol (ethynyl)

Estradiol and felodipine can reduce the serum concentration of 25-OHD and affect other bone metabolism indexes to some extent.